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tci E/M Coding Alert - 2016 Issue 12

Reader Question: Use This E/M Risk Category For Coumadin

Question: In the E/M Table of Risk, where does prescription drug management of Coumadin fall? North Carolina Subscriber Answer: North Carolina’s Part B Medicare administrative contractor (MAC) Palmetto has posted a Q&A stating that “Coumadin is considered a ‘drug therapy requiring intensive monitoring for toxicity.’” In the Table of Risk, that puts Coumadin in the High Risk category. Documentation should include drug levels taken at appropriate intervals, according to Palmetto. Caution: All of your E/M coding should be based on the specific patient encounter, so if the provider doesn’t consider the Coumadin...

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